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Cyclosporine: Moderate Use caution with the coadministration of hydroxychloroquine and cyclosporine as increased serum concentrations of cyclosporine have been noted. Monitoring cyclosporine concentrations after starting or stopping hydroxychloroquine therapy may be necessary. Monitor patients for cyclosporine-related adverse events such as nephrotoxicity or hepatic toxicity.

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Dapagliflozin: Moderate Careful monitoring of blood glucose is recommended when hydroxychloroquine and antidiabetic agents, including the SGLT2 inhibitors, are coadministered. Dapagliflozin; Metformin: Moderate Careful monitoring of blood glucose is recommended when hydroxychloroquine and antidiabetic agents, including metformin, are coadministered. Dapagliflozin; Saxagliptin: Moderate Careful monitoring of blood glucose is recommended when hydroxychloroquine and antidiabetic agents, including the dipeptidyl peptidase-4 inhibitors, are coadministered.

Darunavir; Cobicistat: Moderate Caution is warranted when cobicistat is administered with hydroxychloroquine as there is a potential for elevated cobicistat concentrations. Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide: Moderate Caution is warranted when cobicistat is administered with hydroxychloroquine as there is a potential for elevated cobicistat concentrations.

Dasatinib: Major Avoid coadministration of hydroxychloroquine and dasatinib. In vitro studies have shown that dasatinib has the potential to prolong the QT interval. Degarelix: Major Avoid coadministration of hydroxychloroquine and degarelix. QTc prolongation has been reported with the use of degarelix.

Desflurane: Major Avoid coadministration of hydroxychloroquine and halogenated anesthestics. Halogenated anesthetics can prolong the QT interval. Desipramine: Major Avoid coadministration of hydroxychloroquine and tricyclic antidepressants. Deutetrabenazine: Major Hydroxychloroquine prolongs the QT interval and should not be administered with other drugs known to prolong the QT interval.

Clinically relevant QTc prolongation may occur with deutetrabenazine. Dextromethorphan; Promethazine: Major Avoid coadministration of hydroxychloroquine and promethazine. Dextromethorphan; Quinidine: Major Avoid coadministration of hydroxychloroquine and quinidine. Quinidine administration is associated with QT prolongation and TdP. Diazepam: Moderate Caution is warranted with the coadministration of hydroxychloroquine and antiepileptic drugs, such as diazepam.

Digoxin: Moderate Digoxin serum concentrations have been reported to increase when hydroxychloroquine was added. Hydroxychloroquine may inhibit P-glycoprotein P-gp. Digoxin is a substrate for P-gp transport. For patients on a stable digoxin regimen and initiating hydroxychloroquine, no initial dose adjustment of either drug has been advised; however, serum digoxin concentrations should be monitored and used for digoxin dose titration as clinically necessary.

Dihydrocodeine; Guaifenesin; Pseudoephedrine: Moderate Concomitant use of dihydrocodeine with hydroxychloroquine may increase dihydrocodeine plasma concentrations, but decrease the plasma concentration of the active metabolite, dihydromorphine, resulting in reduced efficacy or symptoms of opioid withdrawal.

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Dipeptidyl Peptidase-4 Inhibitors: Moderate Careful monitoring of blood glucose is recommended when hydroxychloroquine and antidiabetic agents, including the dipeptidyl peptidase-4 inhibitors, are coadministered. Diphenhydramine; Hydrocodone; Phenylephrine: Moderate Concomitant use of hydrocodone with hydroxychloroquine may increase hydrocodone plasma concentrations and prolong opioid adverse reactions, including hypotension, respiratory depression, profound sedation, coma, and death.

Disopyramide: Major Avoid coadministration of hydroxychloroquine and disopyramide. Disopyramide administration is also associated with QT prolongation and TdP. Dofetilide: Major Coadministration of dofetilide and hydroxychloroquine is not recommended as concurrent use may increase the risk of QT prolongation. Dolasetron: Major Avoid coadministration of hydroxychloroquine and dolasetron. Dolutegravir; Rilpivirine: Major Avoid coadministration of hydroxychloroquine and rilpivirine. Donepezil: Major Avoid coadministration of hydroxychloroquine and donepezil.

Case reports indicate that QT prolongation and TdP can occur during donepezil therapy. Donepezil is considered a drug with a known risk of TdP. Donepezil; Memantine: Major Avoid coadministration of hydroxychloroquine and donepezil. Doxepin: Major Avoid coadministration of hydroxychloroquine and tricyclic antidepressants. Clinically significant interactions have been reported when doxorubicin was coadministered with inhibitors of CYP2D6, resulting in increased concentration and clinical effect of doxorubicin. Avoid coadministration of hydroxychloroquine and doxorubicin if possible.

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If not possible, closely monitor for increased side effects of doxorubicin including myelosuppression and cardiotoxicity. Dronedarone: Severe Dronedarone administration is associated with a dose-related increase in the QTc interval. The increase in QTc is approximately 10 milliseconds at doses of mg twice daily the FDA-approved dose and up to 25 milliseconds at doses of mg twice daily. Although there are no studies examining the effects of dronedarone in patients receiving other QT prolonging drugs, coadministration of such drugs may result in additive QT prolongation.

Because of the potential for torsade de pointes, use of hydroxychloroquine with dronedarone is contraindicated. Droperidol: Major Avoid coadministration of hydroxychloroquine and droperidol. Droperidol administration is associated with an established risk for QT prolongation and torsade de pointes TdP. Dulaglutide: Moderate Careful monitoring of blood glucose is recommended when hydroxychloroquine and antidiabetic agents, including the incretin mimetics, are coadministered.

Efavirenz: Major Avoid coadministration of hydroxychloroquine and efavirenz. QTc prolongation has been observed with the use of efavirenz. Efavirenz; Emtricitabine; Tenofovir: Major Avoid coadministration of hydroxychloroquine and efavirenz. Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate: Major Avoid coadministration of hydroxychloroquine and efavirenz.

Eliglustat: Major Avoid coadministration of hydroxychloroquine and eliglustat. Coadministration with CYP2D6 inhibitors may increase eliglustat exposure and the risk of serious adverse events e. If coadministration is necessary in extensive or intermediate CYP2D6 metabolizers EMs or IMs , a dose reduction of eliglustat to 84 mg PO once daily is necessary; however, coadministration of eliglustat with both hydroxychloroquine and a strong or moderate CYP3A inhibitor is contraindicated.

Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide: Moderate Caution is warranted when cobicistat is administered with hydroxychloroquine as there is a potential for elevated cobicistat concentrations.

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Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate: Moderate Caution is warranted when cobicistat is administered with hydroxychloroquine as there is a potential for elevated cobicistat concentrations. Empagliflozin: Moderate Careful monitoring of blood glucose is recommended when hydroxychloroquine and antidiabetic agents, including the SGLT2 inhibitors, are coadministered. Empagliflozin; Linagliptin: Moderate Careful monitoring of blood glucose is recommended when hydroxychloroquine and antidiabetic agents, including the dipeptidyl peptidase-4 inhibitors, are coadministered.

Empagliflozin; Linagliptin; Metformin: Moderate Careful monitoring of blood glucose is recommended when hydroxychloroquine and antidiabetic agents, including metformin, are coadministered. Empagliflozin; Metformin: Moderate Careful monitoring of blood glucose is recommended when hydroxychloroquine and antidiabetic agents, including metformin, are coadministered.

Emtricitabine; Rilpivirine; Tenofovir alafenamide: Major Avoid coadministration of hydroxychloroquine and rilpivirine. Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate: Major Avoid coadministration of hydroxychloroquine and rilpivirine. Caution is recommended when administering encainide with CYP2D6 inhibitors, such as hydroxychloroquine, since encainide exhibits a narrow therapeutic range and large increases in serum concentrations may be associated with severe adverse reactions.

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Encorafenib: Major Avoid coadministration of encorafenib and hydroxychloroquine due to QT prolongation. Encorafenib is associated with dose-dependent prolongation of the QT interval. Hydroxychloroquine prolongs the QT interval and should not be administered with other drugs known to prolong the QT interval. Enflurane: Major Avoid coadministration of hydroxychloroquine and halogenated anesthestics. Entrectinib: Major Avoid coadministration of entrectinib with hydroxychloroquine due to the risk of QT prolongation.

Entrectinib has been associated with QT prolongation. Hydroxychloroquine also prolongs the QT interval. Eribulin: Major Avoid coadministration of hydroxychloroquine and eribulin. Eribulin has been associated with QT prolongation.


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If eribulin and another drug that prolongs the QT interval must be coadministered, ECG monitoring is recommended; closely monitor the patient for QT interval prolongation. Ertugliflozin: Moderate Careful monitoring of blood glucose is recommended when hydroxychloroquine and antidiabetic agents, including the SGLT2 inhibitors, are coadministered. Ertugliflozin; Metformin: Moderate Careful monitoring of blood glucose is recommended when hydroxychloroquine and antidiabetic agents, including metformin, are coadministered. Ertugliflozin; Sitagliptin: Moderate Careful monitoring of blood glucose is recommended when hydroxychloroquine and antidiabetic agents, including the dipeptidyl peptidase-4 inhibitors, are coadministered.

Erythromycin: Major Avoid coadministration of hydroxychloroquine and erythromycin. Erythromycin is associated with QT prolongation and TdP. Erythromycin; Sulfisoxazole: Major Avoid coadministration of hydroxychloroquine and erythromycin. Escitalopram: Major Avoid coadministration of hydroxychloroquine and escitalopram. Escitalopram has been associated with a risk of QT prolongation and TdP.

Eslicarbazepine: Moderate Caution is warranted with the coadministration of hydroxychloroquine and antiepileptic drugs, such as eslicarbazepine.